Symptoms of acute otitis media
Last reviewed: 23.04.2024
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There are serious differences in symptoms of acute otitis media in children and adults.
Acute otitis media is easy: the general condition does not change, there is no temperature reaction, in the anamnesis more often - ARVI. When the otoscopy of the tympanic membrane is almost not changed, occasionally determine the level of exudate. Complaints of patients - a decrease in hearing, a feeling of stuffiness in the ear. In children of early and preschool age, complaints can be absent due to fear of examination by a doctor, so the role of the pediatrician in case of suspected hearing loss should be more active, and the child should be sent to a hearing specialist for an otorhinolaryngologist.
Recurrent otitis media is met in children aged 2 to 5 years. The clinical course is usually relatively easier. The disease occurs in two forms: with and without perforation. The first symptom is a slight pain in the ear and a feeling of stuffiness. However, in this period, unfortunately, the disease is often not diagnosed, since children do not always complain about hearing loss, especially in a one-way process, there is no temperature reaction, as a rule, no intoxication. To establish the diagnosis in this period, it is important to study the auditory function with acoustic impedance measurement.
Adhesive otitis media is a consequence of the unfavorable course of acute otitis media. As already noted, the criteria for recovery are resorption of the exudate in the tympanic cavity and complete restoration of the auditory function. However, sometimes even with active treatment with antibiotics, this exudate becomes sterile, the temperature and pain disappear, a visible recovery occurs. This is most often the case with poor drainage function of the auditory tube, the absence of perforation of the tympanic membrane or paracentesis that was not done in a timely manner. Indeed, the general state of the child becomes normal, like the otoscopic picture. Only deafness is preserved, and sometimes - noise in the ear. This situation requires active audiological diagnosis, since children, as a rule, do not complain about hearing loss. Each case of acute acute otitis media in a child requires confirmation of a normal auditory function.
If the exudate begins to organize, and the fibrous filaments become spikes, then the sound is disturbed, a persistent hearing loss of a sound-conducting character occurs. Audiologic research indicates the defeat of the sound function.
Symptoms of acute otitis media are diverse and largely dependent on age, it is most difficult to establish a diagnosis in newborns and infants. An important role for diagnosis is the history. It is necessary to find out, after which there was a deterioration in the state of the child. Most often the ear infection is preceded by acute rhinitis, acute respiratory viral infection, sometimes trauma (falling from the crib), allergic diseases.
The leading symptom of acute otitis media is a strong, often sudden, spontaneous pain. It is associated with rapid accumulation of exudate in the tympanic cavity and pressure on the end of the trigeminal nerve, innervating the mucosa. The reaction of a child to pain is expressed in different ways, depending on the age. So, up to 5-6 months the child can not yet determine the localization of pain. That is why he reacts to pain only by shouting, pendulum-like shaking of the head. Sucking on the hands does not help, from breastfeeding refuses, as the movements in the joint of the lower jaw are easily transmitted when sucking on the external auditory canal and drum cavity; Sometimes he prefers to choose a breast opposite to a sick ear. When the ear is down, the pain subsides slightly. With the same is associated with the preferred position of the head in the crib on the sick side, apparently, the heat from the pillow also somewhat reduces the pain. A very common method for pediatricians to investigate the reaction of a child when pressing on a tragus (your symptom) should be treated critically, since a large number of false positive reactions are observed. This study is recommended to be performed during sleep. The same is attributed to the reaction of the child with pressure on the behind-the-bite area, since it is known that at this age the cellular system of the mastoid process has not yet been formed.
An important common symptom is fever. On the second-third day of the disease, it usually rises sharply-up to 39-40 C. However, there is a variant of the course of the disease (the so-called latent otitis), when the temperature is set on the subfebrile digits. Sleeps, screams, at night the condition worsens, sometimes, on the contrary, it becomes oppressed, apathy, refusal of food, vomiting, regurgitation, frequenting of the stool are characteristic.
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